fredklein:If you're Demented (is that even a word?) then do you really have a choice if you go to the hospital?

Depends. If that is all they are coming in for, then yes, they are better off at home. If they can afford having someone relieve the family members keeping an eye on them they will be a lot better off than coming into the hospital. If all they are coming in for is dementia, then they are better off at a care facility that specializes in taking care of people with dementia.

I would never see a "counsellor" if I was having mental health problems. Absolutely anyone can claim to be a counsellor - it's an entirely unregulated area. As a result, there's a horrifying variation in the quality, and I have seen too many patients who have been further psychologically damaged by seeing poorly or under-qualified counsellors.

THIS. SO. MUCH. Even in the US, regulations for who can call themselves a counselor is incredibly limited. It's a bastion for the underqualified and the unscrupulous who make lots of money from people who don't know any better. And the APA is far too busy collecting membership dues from these bad actors to bother cracking down (and it's a real shame; the field of psychology is so filled with woo peddlers that the influence of evidence-based practitioners gets drowned out) And then people wonder why the general public doesn't take mental health issues as seriously as they should.

If you need mental health care, see a psychiatrist or a psychologist, or any person who has a title that requires you to actually prove you have some systemic knowledge about the field you're working in.

It's taken me years of medical experience to realise that just because a therapy doesn't have evidence behind it doesn't mean it can't help some people.

I understand the hesitance to discount unproven therapies, but at the same time, if you think it works... then do the research and show whether it works or not. I wouldn't want a patient of mine to waste money on an unproven therapy that, more often than not, either does nothing, or worse, has the potential to cause tremendous harm (eg: the misuse of chelation therapy to treat autism)

To quote Tim Minchin: "You know what they call alternative medicine that's been proved to work?Medicine."

I think that as a (non) doctor, I will disregard all articles that claim prostate cancer is highly overrated and to be tested causes massive stress, then immediately states that sunbathing will kill you because we all underestimate skin cancer

fredklein:If you're Demented (is that even a word?) then do you really have a choice if you go to the hospital?

A lot of demented people end up in hospital because there is nowhere else for them. It's a wholly unsatisfactory situation all round; they don't get the care they need and they occupy beds which could be used for patients who would benefit.

Prostate cancer is far more common - and, usually, less serious - than most people realise. In elderly men, it's virtually a state of normality. Most of these prostate cancers lie dormant and harmless, and are something men die with, not of. So having a PSA may end up giving you information you would have been better off not knowing. That's if you can trust the result: it's notorious for inaccuracies, with false positives, false negatives and an inability to distinguish between harmless pussycat prostate cancers and the less common aggressive tigers.

Which is why, when men ask for the test, they're potentially opening Pandora's box. We try to guide them through the maze of ifs, buts and maybes. Sure, in theory it could save your life. But in practice it could well lead to worry, unpleasant biopsies and unnecessary, traumatic surgery. Tony Copperfield, GP and author of Sick NotesOr it would have given my grandfather more years with his children, grandchildren, and great grandchildren instead of having to die confused and in pain in a hospice.

el_pilgrim:I think that as a (non) doctor, I will disregard all articles that claim prostate cancer is highly overrated and to be tested causes massive stress, then immediately states that sunbathing will kill you because we all underestimate skin cancer

My 56 y/o brother had the aggressive form of prostate cancer, so I @50 had my PSA level checked. It was quite low. I had no anxiety waiting for the test result. My understanding of the test is that it's not the actual PSA level that means the most, it's a rapid increase of the level from one year to the next that means more testing is in order. Without a baseline, the number can't tell you much unless it's extremely high.

The My Little Pony Killer:Or it would have given my grandfather more years with his children, grandchildren, and great grandchildren instead of having to die confused and in pain in a hospice.

People can die from unnecessary biopsies and surgeries, too - and sometimes it can be more than are saved, if the false positive rate is high or the danger of the treated condition is low. This is the kind of thing that really has to be examined with large-scale studies and statistics.

Yeah, let's pick ONE doctor per question and let his/her response appear to speak for the whole medical profession. I don't know who is more irresponsible, the crackpot doc who advised against getting a flu shot, or the paper for printing it without rebuttal.

The My Little Pony Killer:Prostate cancer is far more common - and, usually, less serious - than most people realise. In elderly men, it's virtually a state of normality. Most of these prostate cancers lie dormant and harmless, and are something men die with, not of. So having a PSA may end up giving you information you would have been better off not knowing. That's if you can trust the result: it's notorious for inaccuracies, with false positives, false negatives and an inability to distinguish between harmless pussycat prostate cancers and the less common aggressive tigers.

Which is why, when men ask for the test, they're potentially opening Pandora's box. We try to guide them through the maze of ifs, buts and maybes. Sure, in theory it could save your life. But in practice it could well lead to worry, unpleasant biopsies and unnecessary, traumatic surgery.Tony Copperfield, GP and author of Sick NotesOr it would have given my grandfather more years with his children, grandchildren, and great grandchildren instead of having to die confused and in pain in a hospice.

I don't agree with him, either (at least, not the absoluteness of his response); as a medical professional, you have a level of training that allows you to be nuanced and make informed decisions. And that means knowing to be cautious about test results that has a decent potential to cause error, having open communication with other staff (namely, the med tech that knows the tests inside and out) and to effectively discuss relevant information with your patients.

Nonetheless, that is a very real challenge of health care. For every life a test prolongs, it may also cause significant costs to a lot of other people who, as a result, seek expensive and unnecessary treatments. Especially in the United States, where medical treatment is the cause of about 50% of all bankruptcies, it is not a concern to dismiss lightly.

Mitrovarr:The My Little Pony Killer: Or it would have given my grandfather more years with his children, grandchildren, and great grandchildren instead of having to die confused and in pain in a hospice.

People can die from unnecessary biopsies and surgeries, too - and sometimes it can be more than are saved, if the false positive rate is high or the danger of the treated condition is low. This is the kind of thing that really has to be examined with large-scale studies and statistics.

Sure, but to tell people to just plain not get tested for this is irresponsible on their part.